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Post menopausal bleeding as a risk factor for endometrial carcinoma.

C D White1

  • 1Department of Obstetrics and Gynecology, Marietta Memorial Hospital, Ohio.

The West Virginia Medical Journal
|January 1, 1991
PubMed
Summary

Postmenopausal bleeding (PMB) is a significant indicator of endometrial carcinoma. Early evaluation is crucial, as higher tumor grades and tissue volume removed during curettage correlate with malignancy.

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Area of Science:

  • Gynecology
  • Oncology
  • Pathology

Background:

  • Postmenopausal bleeding (PMB) is a common gynecological concern.
  • Endometrial sampling is a standard diagnostic procedure for PMB.
  • Distinguishing benign from malignant causes of PMB is critical for patient management.

Purpose of the Study:

  • To evaluate the diagnostic yield of endometrial sampling for postmenopausal bleeding.
  • To identify risk factors and clinical characteristics associated with endometrial carcinoma in patients with PMB.
  • To assess the correlation between preoperative biopsy findings and hysterectomy findings in endometrial carcinoma.

Main Methods:

  • Retrospective review of 133 patients undergoing endometrial sampling for PMB between July 1985 and January 1989.
  • Histopathological analysis of endometrial biopsy specimens.
  • Comparison of clinical data, tumor grade, and tissue volume between benign and malignant cases.

Main Results:

  • Endometrial carcinoma was diagnosed in 14.3% of patients (19/133), with an average age of 65 years.
  • Benign histology was observed in 85.7% of patients (114/133), with an average age of 58.6 years.
  • A higher tumor grade at hysterectomy was noted in 26.3% of carcinoma patients compared to biopsy. Greater tissue volume removed during curettage was associated with carcinoma.

Conclusions:

  • Postmenopausal bleeding is a significant predictor of endometrial carcinoma and necessitates thorough evaluation.
  • Factors such as hormonal therapy, symptom duration, hypertension, obesity, and diabetes were not significant risk factors in this cohort.
  • Intraoperative assessment of tumor grade and invasion depth is vital for surgical planning in endometrial carcinoma cases.

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